Emergency nurses and the care of people who have self-harmed: A meta-ethnography

Self-harm is a significant public health issue and a key focus of health policies globally. Emergency departments (EDs) often see self-harm cases, with emergency nurses playing a crucial role. However, care is inconsistent and substandard due to a lack of evidence-based practices and mixed attitudes among nurses.

To understand the social context of emergency nurses' practice with self-harm patients by synthesising qualitative research findings.

Noblit and Hare's meta-ethnography method was used to synthesise qualitative studies. Three databases (PsychINFO, CINAHL, and MEDLINE) were searched for relevant studies over the period October 2013 to July 2025. Five studies with rich qualitative data were included.

Nurses often feel discomfort and uncertainty when caring for self-harm patients due to a lack of knowledge and confidence. Emotional responses like frustration and anger can negatively impact care quality. Service barriers, including time constraints, lack of privacy, and inadequate guidelines, further hinder optimal care. However, with experience and education, nurses develop greater comfort and skills. The presence of mental health specialists in EDs enhances nurses' confidence and care quality. Focused education and training are crucial for changing attitudes and improving care for self-harm patients.

The meta-ethnography highlights the need for improved education and training for ED nurses in mental health care. Enhancing the physical environment of EDs and fostering a culture of shared responsibility for mental health care can improve service users' outcomes and professional satisfaction for nurses.